TY - JOUR
T1 - Association of pregnancies with risk of multiple sclerosis
AU - Gasperi, Christiane
AU - Hapfelmeier, Alexander
AU - Schneider, Antonius
AU - Kuhn, Klaus A.
AU - Donnachie, Ewan
AU - Hemmer, Bernhard
N1 - Publisher Copyright:
© The Author(s), 2022.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Pregnancies have an impact on the disease course of multiple sclerosis (MS), but their relationship with MS risk is yet unclear. Objective: To determine the relationships of pregnancies and gynecological diagnoses with MS risk. Methods: In this retrospective case–control study, we assessed differences in gynecological International Classification of Diseases, 10th Revision (ICD-10) code recording rates between women with MS (n = 5720), Crohn’s disease (n = 6280), or psoriasis (n = 40,555) and women without these autoimmune diseases (n = 26,729) in the 5 years before diagnosis. Results: Twenty-eight ICD-10 codes were recorded less frequently for women with MS as compared to women without autoimmune disease, 18 of which are pregnancy-related. After adjustment for pregnancies, all codes unrelated to pregnancies were still negatively associated with MS. In a sensitivity analysis excluding women with evidence for possible demyelinating events before diagnosis, all associations were more pronounced. In comparison to women with psoriasis, most associations could be confirmed; that was not true in comparison to women with Crohn’s disease. Conclusion: Our findings provide evidence for a possible protective effect of pregnancies on MS risk likely independent of or in addition to a previously suggested reversed causality. The negative associations of gynecological disorders with disease risk need further investigation. The associations might be shared by different autoimmune diseases.
AB - Background: Pregnancies have an impact on the disease course of multiple sclerosis (MS), but their relationship with MS risk is yet unclear. Objective: To determine the relationships of pregnancies and gynecological diagnoses with MS risk. Methods: In this retrospective case–control study, we assessed differences in gynecological International Classification of Diseases, 10th Revision (ICD-10) code recording rates between women with MS (n = 5720), Crohn’s disease (n = 6280), or psoriasis (n = 40,555) and women without these autoimmune diseases (n = 26,729) in the 5 years before diagnosis. Results: Twenty-eight ICD-10 codes were recorded less frequently for women with MS as compared to women without autoimmune disease, 18 of which are pregnancy-related. After adjustment for pregnancies, all codes unrelated to pregnancies were still negatively associated with MS. In a sensitivity analysis excluding women with evidence for possible demyelinating events before diagnosis, all associations were more pronounced. In comparison to women with psoriasis, most associations could be confirmed; that was not true in comparison to women with Crohn’s disease. Conclusion: Our findings provide evidence for a possible protective effect of pregnancies on MS risk likely independent of or in addition to a previously suggested reversed causality. The negative associations of gynecological disorders with disease risk need further investigation. The associations might be shared by different autoimmune diseases.
KW - Multiple sclerosis
KW - autoimmune diseases
KW - case–control studies
KW - health services research
KW - pregnancy
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85126601479&partnerID=8YFLogxK
U2 - 10.1177/13524585221080542
DO - 10.1177/13524585221080542
M3 - Article
C2 - 35301890
AN - SCOPUS:85126601479
SN - 1352-4585
VL - 28
SP - 1630
EP - 1640
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 10
ER -